Review of Outcomes after Salvage Surgery for Recurrent Squamous Cell Carcinoma of the Head and Neck
by
, , , , , , ,
Dana M. Hartl
1,*
,
Joanne Guerlain
1,
Philippe Gorphe
1,
Madan Kapre
2,
Neeti Kapre Gupta
2,
Nabil F. Saba
3,
K. Thomas Robbins
4,
Ohad Ronen
5,
Juan P. Rodrigo
6
,
Primož Strojan
7
,
Antti A. Mäkitie
8,
Luiz P. Kowalski
9,10
,
Jatin P. Shah
11 and
Alfio Ferlito
12
1
Department of Anesthesia, Surgery, and Interventional Radiology, Head and Neck Oncology Service, 94805 Villejuif, France
2
Department of ENT and Head Neck Surgery, Neeti Clinics Nagpur, Nagpur 440010, India
3
The Winship Cancer Institute, Emory University, Atlanta, GA 30322, USA
4
Department of Otolaryngology Head and Neck Surgery, Southern Illinois University Medical School, Springfield, IL 62703, USA
5
Department of Otolaryngology—Head and Neck Surgery, Galilee Medical Center Affiliated with Azrieli Faculty of Medicine, Bar Ilan University, Safed 5290002, Israel
6
Department of Otolaryngology, Hospital Universitario Central de Asturias, University of Oviedo, IUOPA, ISPA, CIBERONC, 33204 Oviedo, Spain
7
Institute of Oncology Ljubljana, 1000 Ljubljana, Slovenia
8
Department of Otorhinolaryngology—Head and Neck Surgery, Research Program in Systems Oncology, University of Helsinki and Helsinki University Hospital, FI-00029 Helsinki, Finland
9
Head and Neck Surgery Department, University of São Paulo Medical School, Sao Paulo 05403-000, Brazil
10
Head and Neck Surgery and Otorhinolaryngology Department, A C Camargo Cancer Center, Sao Paulo 01509-001, Brazil
11
Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
12
Coordinator of the International Head and Neck Scientific Group, 35100 Padua, Italy
*
Author to whom correspondence should be addressed.
Cancers 2023, 15(19), 4692; https://doi.org/10.3390/cancers15194692
Submission received: 22 August 2023
/
Revised: 14 September 2023
/
Accepted: 20 September 2023
/
Published: 23 September 2023
(This article belongs to the Section Cancer Causes, Screening and Diagnosis)
Simple Summary
Local recurrences, isolated regional recurrences, and loco-regional recurrences are frequent after treatment for advanced stage head and neck squamous cell carcinoma. Salvage surgery may be possible in selected patients, taking into account the location and stage of the recurrent disease, patient age and comorbidities, tumor HPV status, and functional sequelae in relation to initial therapy. Results vary according to these parameters. Adjuvant treatments after salvage surgery are under investigation. The aim of this review is to present current knowledge concerning the incidence and management of recurrent head and neck squamous cell carcinoma and current data concerning survival and morbidity after salvage surgery.
Abstract
Surgery with adjuvant chemoradiotherapy or chemoradiotherapy is the mainstay in treatment for advanced stage head and neck squamous cell carcinoma; however, locoregional recurrences are frequent. Salvage surgery could be proposed in selected patients to improve local control, disease-free, and overall survival. Factors for improved disease-free and overall survival in patients treated with salvage surgery include age, tumor location, the initial T stage, HPV status, resection margins, and the time elapsing from the initial treatment. Clinical trials with adjuvant therapies have shown promise after salvage surgery in terms of tolerance and response, but clinical guidelines for using these adjuvant treatments are currently lacking. The aim of this review is to present current knowledge concerning the incidence and management of recurrent head and neck squamous cell carcinoma and current data concerning survival and morbidity after salvage surgery.
Keywords:
head and neck cancer; squamous cell; chemoradiation; salvage surgery
